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计划性与非计划性剖宫产术后恢复质量:使用产科恢复质量-10 工具的前瞻性观察性研究。

Quality of Recovery After Unplanned and Planned Cesarean Deliveries: A Prospective Observational Study Using the Obstetric Quality of Recovery-10 Tool.

机构信息

From the Department of Anesthesia and Pain Management, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.

出版信息

Anesth Analg. 2024 Oct 1;139(4):754-760. doi: 10.1213/ANE.0000000000006876. Epub 2024 Feb 21.

Abstract

BACKGROUND

There is a paucity of literature examining the differences between patient-reported outcome measures after planned and unplanned cesarean delivery using a validated quality of recovery tool. The Obstetric Quality of Recovery-10 (ObsQoR-10) scoring tool has been validated to quantify functional recovery after cesarean delivery. We aimed to use the ObsQoR-10 to compare the postoperative recovery characteristics of patients undergoing planned and unplanned cesarean deliveries.

METHODS

We conducted a prospective single-center observational study. Patients undergoing planned and unplanned cesarean deliveries under neuraxial anesthesia were asked to complete the ObsQoR-10 questionnaire 24 hours, 48 hours, and 1 week postpartum. We collected information on total in-hospital postoperative opioid consumption and patients´ perception of readiness for discharge at 24 and 48 hours postpartum. Additionally, patient characteristics were collected to assess their correlation with our findings.

RESULTS

We included 112 patients (56 in each group). No statistical differences in ObsQoR-10 scores at 24 hours, 48 hours, and 1 week postpartum were observed between the planned and unplanned cesarean deliveries. Additionally, there was no difference between the groups in patients' perception of readiness for hospital discharge at 24 and 48 hours and opioid consumption in the first 2 days after surgery. Most patients in both groups did not think they would be ready for discharge at 24 hours postpartum. Analysis of the individual components of ObsQoR-10 at 24 hours showed a difference in the responses assessing the severity of shivering (higher in unplanned cesarean deliveries) and the ability to look after personal hygiene (lower in unplanned cesarean deliveries).

CONCLUSIONS

As assessed by the ObsQoR-10, no significant difference in the quality of recovery was observed between patients undergoing planned and unplanned cesarean delivery.

摘要

背景

使用经过验证的恢复质量工具,评估计划剖宫产和非计划剖宫产患者报告的术后结局指标的差异的文献很少。产科恢复质量评分-10 量表(ObsQoR-10)已被验证可用于量化剖宫产术后的功能恢复。我们旨在使用 ObsQoR-10 比较计划和非计划剖宫产患者的术后恢复特征。

方法

我们进行了一项前瞻性单中心观察性研究。接受椎管内麻醉下计划和非计划剖宫产的患者在产后 24 小时、48 小时和 1 周时被要求完成 ObsQoR-10 问卷。我们收集了术后总住院期间阿片类药物消耗和患者在产后 24 小时和 48 小时对出院准备情况的感知信息。此外,还收集了患者特征信息以评估其与我们研究结果的相关性。

结果

我们纳入了 112 名患者(每组 56 名)。计划和非计划剖宫产患者在产后 24 小时、48 小时和 1 周时 ObsQoR-10 评分无统计学差异。此外,两组患者在产后 24 小时和 48 小时对出院准备情况的感知以及术后前 2 天的阿片类药物消耗方面无差异。两组大多数患者认为他们在产后 24 小时时还没有准备好出院。在产后 24 小时时对 ObsQoR-10 各个组成部分的分析显示,在评估寒战严重程度(非计划剖宫产组较高)和个人卫生自理能力(非计划剖宫产组较低)方面的反应存在差异。

结论

根据 ObsQoR-10,计划剖宫产和非计划剖宫产患者的恢复质量无显著差异。

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